Which client in a long-term care facility should the nurse see first?

A. A resident whose family wants an update on weight
B. A resident with a new onset of confusion and a temperature of 100.8°F (38.2°C)
C. A resident who wants to change rooms
D. A resident with chronic knee pain asking for a scheduled analgesic

Show answer and rationale

Correct answer: B

Acute confusion with fever in an older adult may signal sepsis or another acute illness and needs prompt assessment.

Source: Lewis's Medical-Surgical Nursing, 13th ed. (older adults)

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This question is one of 193 Management of Care items in NCLEXSim. On the NCLEX-RN, this category makes up 15–21% of the exam.

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Study tip

Work every 'who first' item through the same ladder: airway, breathing, circulation; then unstable before stable, acute before chronic, actual before potential.
Delegation: the RN keeps initial assessment, care planning, teaching, evaluation, and any unstable client. LPNs take stable, predictable clients. Assistive personnel take routine tasks such as vital signs on stable clients, hygiene, feeding without swallowing risk, and ambulation.

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Which client in a long-term care facility should the nurse see first?

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